I 

118TH CONGRESS 

2D SESSION H. R. 9179 

To amend title 38, United States Code, to establish the Office of Falls 

Prevention of the Department of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 26, 2024 

Ms. BUDZINSKI (for herself, Ms. LOIS FRANKEL of Florida, Mrs. KIGGANS

of Virginia, Mr. BERGMAN, and Mr. BILIRAKIS) introduced the following 

bill; which was referred to the Committee on Veterans’ Affairs, and in 

addition to the Committee on Education and the Workforce, for a period 

to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee 

concerned 

A BILL 

To amend title 38, United States Code, to establish the 

Office of Falls Prevention of the Department of Veterans 

Affairs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Supporting Access to 

5 Falls Education and prevention and Strengthening Train6 ing Efforts and Promoting Safety initiatives for Veterans 


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1 Act of 2024’’ or the ‘‘SAFE STEPS for Veterans Act of 

2 2024’’. 

3 SEC. 2. ESTABLISHMENT OF OFFICE OF FALLS PREVEN4 TION OF DEPARTMENT OF VETERANS AF5 FAIRS. 

6 (a) ESTABLISHMENT OF OFFICE.— 

7 (1) IN GENERAL.—Subchapter I of chapter 73 

8 of title 38, United States Code, is amended by in9 serting after section 7310A the following new sec10 tion: 

11 ‘‘§ 7310B. Office of Falls Prevention 

12 ‘‘(a) OFFICE.— 

13 ‘‘(1) ESTABLISHMENT AND OPERATION.—The 

14 Under Secretary for Health shall establish and oper15 ate in the Veterans Health Administration the Office 

16 of Falls Prevention (in this section referred to as the 

17 ‘Office’). 

18 ‘‘(2) LOCATION OF OFFICE.—The Office shall 

19 be located at the Central Office of the Department. 

20 ‘‘(3) LEADERSHIP.— 

21 ‘‘(A) HEAD.—The head of the Office is the 

22 Chief Officer of Falls Prevention (in this sec23 tion referred to as the ‘Chief Officer’). 

24 ‘‘(B) REPORTING.—The Chief Officer shall 

25 report to the Under Secretary for Health. 


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1 ‘‘(4) STAFFING AND SUPPORT.—The Under 

2 Secretary for Health shall provide the Office with 

3 such staff and other support as may be necessary 

4 for the Office to carry out effectively the functions 

5 of the Office under this section. 

6 ‘‘(5) REORGANIZATION.—The Under Secretary 

7 for Health may reorganize existing offices within the 

8 Veterans Health Administration as of the date of 

9 the enactment of this section in order to avoid dupli10 cation with the functions of the Office. 

11 ‘‘(b) FUNCTIONS.—The functions of the Office in12 clude the following: 

13 ‘‘(1) To provide a central office for monitoring 

14 and encouraging the activities of the Veterans 

15 Health Administration with respect to the provision, 

16 evaluation, and improvement of health care services 

17 relating to falls prevention provided to veterans by 

18 the Department, with the goal of averting costly 

19 health care utilization while decreasing the incidence 

20 of falls. 

21 ‘‘(2) To develop and implement standards of 

22 care for the provision by the Department of health 

23 care services relating to falls prevention. 

24 ‘‘(3) To monitor and identify deficiencies in 

25 standards of care for the provision of health care 


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1 services relating to falls prevention, to provide tech2 nical assistance to medical facilities of the Depart3 ment, to provide technical assistance to programs of 

4 the Department that support veterans in their own 

5 homes, to address and remedy deficiencies of such 

6 facilities and programs, and to perform oversight of 

7 implementation of such standards of care. 

8 ‘‘(4) To monitor and identify deficiencies in 

9 standards of care for the provision of health care 

10 services relating to falls prevention through the com11 munity pursuant to this title and to provide rec12 ommendations to the appropriate office to address 

13 and remedy any deficiencies. 

14 ‘‘(5) To oversee distribution of resources and 

15 information related to falls prevention for veterans 

16 under this title. 

17 ‘‘(6) To promote the expansion and improve18 ment of clinical, research, and educational activities 

19 of the Veterans Health Administration with respect 

20 to health care services relating to falls prevention, 

21 including research activities on falls prevention con22 ducted between the Office of Research and Develop23 ment of the Department and the National Institute 

24 on Aging. 


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1 ‘‘(7) To promote the development or expansion 

2 of rigorous quality assessment or improvement proc3 esses designed to prevent falls, including through co4 ordination and collaboration with offices within the 

5 Department determined appropriate by the Sec6 retary. 

7 ‘‘(8) To coordinate home modification and ad8 aptation programs administered by the Under Sec9 retary for Benefits under chapter 21 of this title and 

10 the Under Secretary for Health under section 

11 1717(a)(2) of this title. 

12 ‘‘(9) To carry out such other duties as the 

13 Under Secretary for Health may require. 

14 ‘‘(c) PUBLIC EDUCATION CAMPAIGN.—The Chief Of15 ficer shall— 

16 ‘‘(1) oversee and support a national education 

17 campaign that— 

18 ‘‘(A) is directed principally to veterans de19 termined to be at risk for falls, their families, 

20 and their health care providers; and 

21 ‘‘(B) focuses on— 

22 ‘‘(i) reducing falls, falls with major in23 jury, and repeat falls for veterans receiving 

24 care under the laws administered by the 

25 Secretary; and 


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1 ‘‘(ii) increasing awareness of available 

2 benefits, grants, devices, or services pro3 vided by the Department that would aid 

4 veterans in reducing falls and preventing 

5 repeat falls; and 

6 ‘‘(2) award grants or contracts to qualified or7 ganizations for the purpose of supporting local edu8 cation campaigns focusing on reducing falls, falls 

9 with major injury, and repeat falls for veterans re10 ceiving care under the laws administered by the Sec11 retary. 

12 ‘‘(d) RESEARCH ON FALLS PREVENTION PROGRAMS

13 FOR VETERAN POPULATIONS.— 

14 ‘‘(1) IN GENERAL.—The Chief Officer shall 

15 work with the Office of Research and Development 

16 of the Department and the National Institute on 

17 Aging to develop research for evidence-based falls 

18 prevention programs that will benefit veterans, in19 cluding— 

20 ‘‘(A) programs that overlap with the prior21 ities of the Department; 

22 ‘‘(B) programs that may focus on or be of 

23 particular benefit to veterans; and 

24 ‘‘(C) programs that may include partici25 pants with multiple comorbidities. 


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1 ‘‘(2) MATTERS TO BE INCLUDED.—The re2 search required under paragraph (1) shall include 

3 the following: 

4 ‘‘(A) Research in supporting veterans with 

5 and without service-connected disabilities receiv6 ing home modification grants under section 

7 1717 or 2101 of this title. 

8 ‘‘(B) Development of recommendations for 

9 falls prevention interventions for veterans with 

10 service-connected disabilities, including home 

11 modification interventions. 

12 ‘‘(C) Research addressing medication man13 agement and polypharmacy as risk factors for 

14 falls prevention and developing recommenda15 tions for providers and electronic health records 

16 systems of the Department to monitor for vet17 erans at risk of falls based on use of certain 

18 medications. 

19 ‘‘(D) Research on improvements for safe 

20 patient handling and mobility among veterans, 

21 particularly in facilities (both medical and non22 medical) that are not spinal cord injury centers. 

23 ‘‘(3) SUBJECT MATTER EXPERT PANEL.— 

24 ‘‘(A) IN GENERAL.—The Secretary and the 

25 Director of the National Institute on Aging 


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1 shall establish a joint subject matter expert 

2 panel to develop recommendations as required 

3 under paragraph (2)(B). 

4 ‘‘(B) MEMBERSHIP.—The subject matter 

5 expert panel required under subparagraph (A) 

6 shall be comprised of eight members, of 

7 which— 

8 ‘‘(i) four shall be appointed by the 

9 Secretary; and 

10 ‘‘(ii) four shall be appointed by the 

11 Director of the National Institute on 

12 Aging.’’. 

13 (2) ESTABLISHMENT OF JOINT SUBJECT MAT14 TER EXPERT PANEL.—Not later than 180 days after 

15 the date of the enactment of this Act, the Secretary 

16 of Veterans Affairs and the Director of the National 

17 Institute on Aging shall establish the joint subject 

18 matter expert panel required under section 

19 7310B(d)(3) of title 38, United States Code, as 

20 added by paragraph (1). 

21 (3) CLERICAL AMENDMENT.—The table of sec22 tions at the beginning of such chapter is amended 

23 by inserting after the item relating to section 7310A 

24 the following new item: 

‘‘7310B. Office of Falls Prevention.’’. 


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1 (b) EXPANSION OF INTERAGENCY COORDINATING

2 COMMITTEE ON HEALTHY AGING AND AGE-FRIENDLY

3 COMMUNITIES.—Section 203(c) of the Older Americans 

4 Act of 1965 (42 U.S.C. 3013(c)) is amended— 

5 (1) in paragraph (2), by inserting ‘‘the Sec6 retary of Veterans Affairs,’’ after ‘‘the Commissioner 

7 of Social Security,’’; and 

8 (2) in paragraph (7), in the matter preceding 

9 subparagraph (A)— 

10 (A) by inserting ‘‘the Committee on Vet11 erans’ Affairs of the House of Representatives,’’ 

12 after ‘‘the Committee on Ways and Means of 

13 the House of Representatives,’’; and 

14 (B) by inserting ‘‘the Committee on Vet15 erans’ Affairs of the Senate,’’ after ‘‘the Com16 mittee on Health, Education, Labor, and Pen17 sions of the Senate,’’. 

18 (c) SAFE HANDLING TRANSFER TECHNIQUES.—Not 

19 later than 180 days after the date of the enactment of 

20 this Act, the Secretary of Veterans Affairs shall issue or 

21 update directives of the Veterans Health Administration 

22 for facilities and providers relating to safe patient han23 dling and mobility policies at the national, Veterans Inte24 grated Service Network, and health-care system levels, 

25 which shall include the following: 


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1 (1) Requiring biennial training for providers, 

2 including that all providers be trained in safe patient 

3 handling and use of mobility aids and mobility tech4 niques. 

5 (2) Requiring that any medical facility where 

6 patients may need assistance with transfer or mobil7 ity have access to safe patient handling and mobility 

8 technology appropriate for the setting to enable safe 

9 transfer and mobilization for access to care and ac10 tivities of daily living for veterans who are paralyzed 

11 or who need assistance with mobility. 

12 (3) Requiring that all emergency settings have 

13 immediate access to safe patient handling and mobil14 ity technology to enable safe transfer, fall recovery, 

15 and repositioning. 

16 (d) PILOT PROGRAM ON FALLS PREVENTION INTER17 VENTIONS TIED TO RESIDENTIAL ADAPTATIONS AND AL18 TERATIONS.— 

19 (1) DETERMINATION.—The Secretary of Vet20 erans Affairs shall determine the feasibility and ad21 visability of carrying out a pilot program to provide 

22 home improvements and structural alterations to 

23 prevent falls for all veterans eligible for those serv24 ices under the laws administered by the Secretary. 


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1 (2) PLAN.—Not later than one year after the 

2 date of the enactment of this Act, the Secretary 

3 shall submit to Congress a report— 

4 (A) indicating the plans of the Secretary to 

5 carry out a pilot program to provide home im6 provements and structural alterations to pre7 vent falls for all veterans eligible for those serv8 ices under the laws administered by the Sec9 retary; or 

10 (B) specifying why the Secretary deter11 mined under paragraph (1) that it is not fea12 sible or advisable to carry out such a pilot pro13 gram. 

14 (3) REPORT ON LESSONS LEARNED.—If the 

15 Secretary carries out the pilot program described in 

16 paragraph (1), not later than 180 days after the ter17 mination of the pilot program, the Chief Officer of 

18 Falls Prevention of the Department of Veterans Af19 fairs established under section 7310B(a)(3)(A) of 

20 title 38, United States Code, as added by subsection 

21 (a)(1), shall submit to Congress a report on lessons 

22 learned from the pilot program and any rec23 ommendations on extending or expanding the pilot 

24 program. 

25 (e) REPORT ON FALLS PREVENTION INITIATIVES.— 


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1 (1) IN GENERAL.—Not later than two years 

2 after the date of the enactment of this Act, or one 

3 year after the appointment of the Chief Officer of 

4 Falls Prevention of the Department of Veterans Af5 fairs established under section 7310B(a)(3)(A) of 

6 title 38, United States Code, as added by subsection 

7 (a)(1), whichever occurs first, the Chief Officer, or 

8 the Under Secretary for Health of the Department 

9 of Veterans Affairs if a Chief Officer has not yet 

10 been appointed, shall submit to Congress a report on 

11 falls prevention initiatives within the Department. 

12 (2) ELEMENTS.—The report required by para13 graph (1) shall evaluate, for the three-year period 

14 preceding the date of the enactment of this Act— 

15 (A) screening procedures at facilities of the 

16 Veterans Health Administration for risk of falls 

17 and the prevalence of resulting falls prevention 

18 interventions; 

19 (B) the use by the Department of elec20 tronic health record documentation for risk of 

21 falls among veterans; 

22 (C) the number of home modification 

23 grants provided under either the Home Im24 provements and Structural Alterations Program 

25 of the Department under section 1717 of title 


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1 38, United States Code, or the Specially Adapt2 ed Housing Program of the Department under 

3 section 2101 of such title; 

4 (D) the extent to which grants provided 

5 under the programs specified under subpara6 graph (C) prevent falls among veterans and any 

7 recommendations with respect to such programs 

8 in the case of falls among veterans that were 

9 not prevented; 

10 (E) for veterans eligible for the Home Im11 provements and Structural Alterations Program 

12 of the Department under section 1717 of title 

13 38, United States Code, pursuant to subsection 

14 (a)(2)(B) of such section, the number of home 

15 modification grants provided to each veteran in 

16 receipt of such a grant; 

17 (F) the types of providers that have con18 ducted medical assessments leading to a rec19 ommendation for a home modification tied to 

20 medical necessity, and any recommendations for 

21 legislative or administrative action to expand 

22 the list of providers eligible to conduct medical 

23 assessments leading to a recommendation for a 

24 home modification; 


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1 (G) home evaluation processes that are 

2 conducted in connection with awards made 

3 under the programs specified under subpara4 graph (C) and any recommendations for im5 proving the evaluation and review process; 

6 (H) reporting programs and software of 

7 the Department used to capture incidences of 

8 falls in care sites of the Veterans Health Ad9 ministration and other veterans’ settings; 

10 (I) limitations on uptake and use of cur11 rent prevention, screening, and intervention 

12 programs designed to address falls prevention; 

13 and 

14 (J) recommendations for the Secretary of 

15 Veterans Affairs to work with the Centers for 

16 Disease Control and Prevention, or other enti17 ties determined appropriate by the Secretary, to 

18 better capture data on falls by a veteran occur19 ring in the home or in the community. 

20 SEC. 3. ESTABLISHMENT OF FALLS ASSESSMENT AND FALL 

21 PREVENTION SERVICE REQUIREMENTS FOR 

22 VETERANS. 

23 (a) REQUIRED NURSING HOME CARE.—Section 

24 1710A of title 38, United States Code, is amended by 

25 striking subsection (d) and inserting the following: 


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1 ‘‘(d) In the case of an individual determined by a phy2 sician to have fallen or to have been at risk of falling dur3 ing the previous one-year period, the Secretary shall en4 sure that a licensed physical therapist or a licensed occu5 pational therapist conducts a falls risk assessment for the 

6 individual and provides fall prevention services during the 

7 stay of the individual in the nursing home. 

8 ‘‘(e) The provisions of subsection (a) shall terminate 

9 on September 30, 2028.’’. 

10 (b) EXTENDED CARE SERVICES.—Section 1710B(a) 

11 of such title is amended by adding at the end the following 

12 new paragraph: 

13 ‘‘(7) The conduct of an annual falls risk assess14 ment and the provision of fall prevention services by 

15 a licensed physical therapist or licensed occupational 

16 therapist.’’. 

Æ 


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